Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK.
Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
Expert Rev Cardiovasc Ther. 2023 Jan;21(1):35-56. doi: 10.1080/14779072.2023.2160319. Epub 2023 Jan 8.
Stroke is one of the leading causes of mortality and morbidity globally. Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. It is set to reach epidemic proportions. AF is associated with a five-fold increase in risk of stroke. Strokes caused by AF more often are fatal or result in severe disability. Even though the incidence of stroke has been significantly reduced by oral anticoagulation, AF is thought to account for a significant proportion of cryptogenic strokes where no etiology is identified.
This article reviews the literature related to AF and stroke, pathophysiological insights, diagnosis of AF in stroke patients, and its management (Graphical Abstract).
The pathophysiology of thrombogenesis that links AF and stroke is not well understood and is an area of active research to identify new therapeutic targets to prevent AF and stroke. As the nature of AF and stroke is multifaceted, an integrated care approach to managing AF and stroke is increasingly essential.
中风是全球范围内导致死亡和发病的主要原因之一。心房颤动(AF)是最常见的持续性心律失常。预计其发病率将呈流行趋势。AF 会使中风风险增加五倍。由 AF 引起的中风更常导致致命或严重残疾。尽管口服抗凝剂显著降低了中风的发生率,但 AF 被认为是很大一部分原因不明的隐源性中风的原因。
本文回顾了与 AF 和中风相关的文献、病理生理学见解、中风患者中 AF 的诊断及其管理(示意图)。
将 AF 和中风联系起来的血栓形成的病理生理学尚不清楚,这是一个积极研究的领域,旨在确定预防 AF 和中风的新治疗靶点。由于 AF 和中风的性质是多方面的,因此越来越需要采用综合护理方法来管理 AF 和中风。